Charcoal burning is also popular for suicide pacts made on the internet

Editor—Rajagopal's editorial discussed how strangers can initiate suicide pacts on the internet.¹ The two cited Japanese suicide pacts both used a new suicide method, charcoal burning. These widely publicised pacts were followed by four additional pacts and 13 deaths in two months, all of whom used charcoal burning. The new suicide method entails smouldering barbecue coal in a small and sealed environment, such as a bedroom, with the aim of producing a carbon monoxide chamber in a short time.^2-4

In Hong Kong we had also observed that suicide pacts commonly used charcoal burning to institute death. In 2002 and 2003, 20 of the 22 suicide pacts (91%) used charcoal burning. Of all charcoal burning deaths during the same period, 7% were suicide pacts (unpublished review of coroners' case records for 2002-3, Coroner Court, Hong Kong SAR).

Several characteristics of charcoal burning make it desirable for people who want to commit suicide together. Unlike other methods of suicide, such as jumping and hanging, it can easily be shared. Besides, charcoal burning is often portrayed as non-disfiguring and painless. Hence, passive partners in suicide pacts could be more easily lured into the act.

The internet, apart from connecting otherwise isolated anomies in forming suicide pacts in Japan, has played an important part in spreading the new suicide method across societies. Charcoal burning and cyber suicide pacts are examples of how globalisation and new technology are creating new challenges for global health.